Provider Demographics
NPI:1194833590
Name:FARBER, HAROLD (MD,)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:
Last Name:FARBER
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 MONTGOMERY AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1550
Mailing Address - Country:US
Mailing Address - Phone:610-664-4433
Mailing Address - Fax:610-664-5290
Practice Address - Street 1:9892 BUSTLETON AVENUE
Practice Address - Street 2:STE 204 MOSS PLAZA
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115
Practice Address - Country:US
Practice Address - Phone:215-676-2464
Practice Address - Fax:215-676-5536
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032429E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019422920001Medicaid
PA476403Medicare ID - Type Unspecified
PA0019422920001Medicaid